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Challenges in managing ST elevation myocardial infarction during the COVID-19 pandemic

World Journal of Cardiology 2021年第4期13卷 76-81页

作者： Megan Smith Aniruddha Singh Douglas McElroy Shilpi Mittal Richard Pham Department ofCardiology University of Kentucky College of MedicineBowling GreenKY 42101United States Department of Cardiology Western Kentucky Heart and Lung Research FoundationBowling GreenKY 42101United States Department of Cardiology The Medical CenterBowling GreenKY 42101United States Department of Biology Western Kentucky UniversityBowling GreenKY 42101United States Department of Neurology Vanderbilt University Medical CenterNashvilleTN 37232United States

BACKGROUND Coronavirus disease 2019(COVID-19)may contribute to delayed presentations of acute myocardial *** presentation with late reperfusion is often associated with an increased risk of mechanical complications and adverse *** delays are possible as every patient who is acutely sick is being considered a potential case or a career of ***,standardized personal protective equipment precautions are established for all members of the team,regardless of pending COVID-19 testing which might further add to *** To compare performance measures and clinical outcomes of all patients who presented to our facility with ST elevation myocardial infarction(STEMI)during the COVID-19 pandemic to same time cohort from *** All patients who presented to our facility with STEMI during the pandemic were compared to a matched cohort during the same time period in *** with unknown time of symptom onset and inpatient STEMI patients were *** outcome was major adverse cardiac events(MACE)in-hospital and up to 14 d after STEMI,including death,myocardial infarction,cardiac arrest,or *** differences among groups for continuous variables were tested through ANOVA,using SYSTAT,version ***-square tests of association were used to compare patient characteristics among groups using *** risk scores and associated tests for significance were calculated for discrete variables using MedCalc(MedCalc Software,Ostend,Belgium).RESULTS There was a significantly longer time interval from symptom onset to first medical contact(FMC)in the COVID-19 group(Pfirst electrocardiogram,door-to-balloon time,and FMC to balloon time were not significantly *** right coronary artery was the most common culprit for STEMI in both the *** 60%of patients had one or more obstructive(>50%)lesion(s)remote from the culprit ***-hospital and 14 d MACE were more prevalent in the COVID-19 group

关键词： COVID-19 ST elevation myocardial infarction first medical contact to balloon Major adverse cardiac events Cardiac arrest Death

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